Health Law and Policy Commons^™

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Saint Louis University Journal of Health Law & Policy

No abstract provided.

An Argument For Explicit Public Health Rationale In Lgbtq Antidiscrimination Law As A Tool For Stigma Reduction, Heather A. Walter-Mccabe, M. Killian Kinney

Saint Louis University Journal of Health Law & Policy

The lesbian, gay, bisexual, transgender (inclusive of nonbinary), and queer (collectively, LGBTQ) community is experiencing health inequities at alarming rates. From behavioral health issues, to violence issues, to increased rates of homelessness, structural stigma impacts LGBTQ communities at a disproportionate rate. Suicide numbers are particularly concerning. The LGB community rate of suicide is two to three times that of the general population. For the transgender and nonbinary community, that number soars to nearly nine times that of the general population. In this article, we examine the social determinates of health impacting the LGBTQ community and the ways structural stigma supports …

#Metoo Meets The Emergency Room: Providing And Paying For Care After A Sexual Assault, Stacey L. Worthy, Shruti R. Kulkarni, Taylor J. Kelly, Jessica Johnson

Saint Louis University Journal of Health Law & Policy

Sexual assault continues to be a major public health problem in the United States. Compounding the problem, survivors of sexual assault all too often face challenges of obtaining and paying for sexual assault forensic exams (SAFEs), commonly referred to as a “rape kit,” and related medical services. Sexual assault survivors who do seek medical care in the emergency department (ED) are often turned away for several reasons, such as EDs determining that sexual assault is not an emergency medical condition, failing to carry SAFEs, or refusing to treat survivors who lack proof of insurance. Denial of care can …

Damage Control Interdisciplinarity: An Antidote To Death Despair In Military Medicine, Erika "Ann" Jeschke

Saint Louis University Journal of Health Law & Policy

“Diseases of despair” is a conceptually broad category used to describe the phenomenon of premature mortality caused by suicide, drug poisoning, and alcoholic liver disease. Central to this conceptualization of mortality is that death occurs too early in an entire population of individuals infected with social despair. Implicit in the diseases of despair construct is a powerful normative claim about the manner and time of death—that death is bad if it is contextualized in unwanted conditions and happens before reaching midlife. As such, diseases of despair ought to be reduced, if not eliminated. Interestingly, military medical research on combat casualties …

A Practical Policy Proposal To Solve The Rural Hospital Puzzle, Brandon M. Hall

Saint Louis University Journal of Health Law & Policy

Since the 1980s, waves of rural hospital closures have intermittently plagued the U.S. health care landscape. Although the Affordable Care Act and its expansion of Medicaid have provided a vital lifeline to rural hospitals over the last decade, policy makers have yet to implement a permanent solution powerful enough to stabilize and offset the institutional and populational constraints that have promulgated the widespread hospital closure crisis plaguing rural communities.

This article argues that rural hospitals need to repurpose themselves to better serve the demands of their patient populations in order to survive the unique demographic and economic challenges they face. …

Taking The Politics Out Of Vaccines: Increasing Vaccination Rates Without Repealing Exemptions, Kylie A. Thompson

Saint Louis University Journal of Health Law & Policy

Vaccinations have become a vital part of disease prevention and public health; however, they remain a controversial topic in our society today. Non-medical exemptions to mandatory vaccination laws are the core of most of the controversy surrounding vaccinations. This Comment examines the controversy surrounding vaccinations and proposes interventions communities can adopt to increase vaccination rates without repealing non-medical exemptions to mandatory vaccination laws.

The Importance Of Standardized Data Collection And Reporting In Improving Medical Care For Immigration Detainees, Allison Michelle Bowen

Saint Louis University Journal of Health Law & Policy

The provision of substandard medical care for immigration detainees has become somewhat of a norm for some time now. From October 1, 2003 to June 5, 2017, alone, there were a total of 172 deaths in ICE custody. This number is only rising as the number of detainee beds increases and ICE continues to not be held accountable. Presently, there lacks a mechanism for oversight and accountability of ICE. This Comment suggests that requiring standardized data collection and reporting efforts is a crucial first step towards improving the medical care for immigration detainees and creating a mechanism for oversight and …

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Introduction, Ruqaiijah Yearby

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Meat Processing Workers And The Covid-19 Pandemic: The Subrogation Of People, Public Health, And Ethics To Profits And A Path Forward, Kelly K. Dineen

Saint Louis University Journal of Health Law & Policy

The COVID-19 pandemic has highlighted and exacerbated existing health injustices. People who are Latino/Latinx, Black, Indigenous or members of other minority groups have disproportionately paid with their very lives. The pandemic has also exposed the complex interdependence of worker health and well-being, community health, and economic security. Industries like meat processing facilities—with congregate and high-density workplaces staffed by workers who are already disadvantaged by structural discrimination—must reckon with decades of subrogation and exploitation of workers. During this pandemic, the industry has pushed that exploitation to a point of no return. Policies to protect workers need a reset to an orientation …

Independent Contractor Misclassification Is Making Everything Worse: The Experience Of Home Care Workers In Maryland, David J. Rodwin

Saint Louis University Journal of Health Law & Policy

The COVID-19 pandemic has exposed and magnified existing problems in the American health care system. One of these problems—existing at the intersections of race, age, disability, class, power, poverty, and health—is the widespread misclassification of home care workers as independent contractors Home care workers, who are predominantly women and people of color, provide personal assistance services and health care supports to older adults and people with disabilities in home- and community-based settings, usually for very low wages. Misclassification cuts them out of the social safety net in case of job loss or injury, imposes a greater tax burden than that …

Accommodating Pregnancy Five Years After Young V. Ups: Where We Are & Where We Should Go, Nicole Buonocore Porter

Saint Louis University Journal of Health Law & Policy

This Article will explore how pregnant employees fare when they are denied accommodations in the workplace that would have allowed them to work safely through their pregnancies. The two most commonly used legal avenues for pregnant plaintiffs are the Pregnancy Discrimination Act (PDA) and the Americans with Disabilities Act (ADA). Successful cases under the ADA were rare until Congress expanded the ADA’s definition of disability in 2008. PDA claims became easier after the Supreme Court’s 2015 decision in Young v. United Parcel Service, Inc. This Article will analyze both the body of PDA cases decided since Young, and all of …

Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align With Evidence-Based Practice?, Candice L. Thomas, Lauren D. Murphy, Drake Van Egdom, Haley R. Cobb

Saint Louis University Journal of Health Law & Policy

Within the United States, there are governmental benefits and policies in place to support breastfeeding mothers as they return to work. However, the effectiveness and inclusiveness of these policies is not always clear. Because of this, breastfeeding at work, in general, and governmental workplace mandates, specifically, often receive negative press and social media attention as women struggle to reconcile their workplace and lactation demands. To provide evidence-based recommendations for how to best support breastfeeding employees, we use an organizational science perspective to review the existing research for evidence on the (1) effectiveness of the existing legal benefits and supports within …

Costs Vs. Compensation: Legal And Policy Recommendations For Addressing Workplace Sexual Harassment, Heather Mclaughlin, Christine Thomas

Saint Louis University Journal of Health Law & Policy

The recent #MeToo Movement has unequivocally shown that workplace sexual harassment is a widespread issue. Since December 2017, workers around the globe have shared personal stories of sexual harassment, as well as the tolls it caused on their health and careers. In this Article, we review extant interdisciplinary research on the negative consequences of sexual harassment for workers’ physical, psychological, and behavioral health; their career and earnings trajectories; and for broader organizational culture. Understanding these costs sheds light on how best to reduce and respond to workplace sexual harassment. We offer three suggestions for law and policy: (1) expand legal …

Expanding Patient Access To Breast Cancer Genetic Testing Through Incentive Regimes, Megan K. Hart

Saint Louis University Journal of Health Law & Policy

It is estimated that 268,600 women were diagnosed with breast cancer in 2019 alone, and as many as 26,860 of these women could have developed breast cancer due to a genetic disposition.[1] While over one million women have undergone genetic testing to identify variations in the BRCA1 and BRCA2 genes, the test results are often ambiguous due to identified variations for which the breast cancer development risk is unknown.[2] A new technology known as CRISPR has the potential to change this state of uncertainty due to its capability to identify thousands of BRCA1 and 2 gene variations and …

The Legal And Ethical Considerations Of The Posthumous Retrieval Of Gametes, Patrick Monahan

Saint Louis University Journal of Health Law & Policy

In the United States, federal and state laws on the issue of posthumous retrieval of gametes are almost non-existent. As the field of medicine continues to grow and more posthumous gamete retrieval procedures become viable, state courts and hospitals are left on their own when patients and family members ask their doctors to perform such procedures. As such, there exists wide variability from hospital to hospital and state to state for a deeply personal and time-sensitive procedure. By reviewing state court cases and hospital policies, this article demonstrates the variability between practices and illustrates key questions that arise when requests …

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Foreword, Sidney D. Watson

Saint Louis University Journal of Health Law & Policy

No abstract provided.

A Program For All Seasons, Sara Rosenbaum

Saint Louis University Journal of Health Law & Policy

From its beginnings as a modest health care companion to cash welfare assistance, Medicaid has become foundational to the American health care system. Medicaid’s success in insuring the poor while continually evolving in response to countless emerging health needs is the result of its public health character, which represents a fundamental departure from the eligibility and coverage strictures and norms on which other forms of insurance depend.

Medicaid’S Role For Seniors And People With Disabilities: Current State Trends, Marybeth Musumeci

Saint Louis University Journal of Health Law & Policy

Medicaid fills a gap in the U.S. health care system as the primary payor for long-term services and supports (LTSS). These services enable seniors, people with disabilities, and those with chronic illnesses to live independently in the community, outside of nursing homes and other institutions. Most Medicaid home and community-based services (HCBS) are covered at state option, unlike nursing home care, which all state Medicaid programs must cover. States have substantial flexibility in designing their Medicaid HCBS programs under federal law, and Medicaid provides an important source of federal funding to states to help meet the LTSS needs of seniors …

Justice And The Struggle For The Soul Of Medicaid, Dayna Bowen Matthew

Saint Louis University Journal of Health Law & Policy

The soul of Medicaid is and always has been to achieve justice in health care. Medicaid at its inception was designed to ensure that the most vulnerable members of society are not excluded from access to good health that all others enjoy. Yet, as the title of this symposium aptly reflects, “The Struggle for the Soul of Medicaid” remains vulnerable to repeated and relentless political attacks. Why is this so, given that the program finances care for nearly sixty-four million Americans?

This article posits that Medicaid is vulnerable because our nation’s commitment to justice in health care remains uncertain. Historically, …

The Administration’S Medicaid Waivers: Exploding In The Guise Of Experimenting, Jane Perkins

Saint Louis University Journal of Health Law & Policy

Congress enacted the Medicaid Act with the stated purpose of furnishing medical assistance to low-income people. Medicaid participation is not required of a state, but if a state does choose to participate—which they all do—the federal government will contribute the lion’s share of the cost of providing care. In return, the state agrees to pay the remaining costs of care. The state must also adhere to the detailed regulatory scheme Congress placed in the Medicaid Act, including requirements for determining eligibility for the program and the scope and affordability of coverage. Section 1115 of the Social Security Act authorizes the …

Social Work As An Important Collaborator In Transdisciplinary Public Health Law: Why Does It Matter And Where Does It Fit?, Heather A. Walter-Mccabe

Saint Louis University Journal of Health Law & Policy

Public health law has been a growing field over the last few decades. From the early days of its initial recognition as an academic and professional field to its more recent texts and treatises, public health law is continuing to define itself. To that end, Burris et al. recently published two works describing a transdisciplinary model of public health law and five essential services of public health law.

This article examines how the inclusion of social work in the model can be instrumental in forming better public health laws. The intentional inclusion of social work collaborators would supplement legal and …

Hypothesizing A Small Opioid Mdl Settlement: An Argument For Local Public Health Action And Lessons From Big Tobacco, Ashton K. Dietrich

Saint Louis University Journal of Health Law & Policy

In response to the opioid epidemic, counties and cities across the United States waged In re: National Prescription Opiate Litigation, better known as the opioid MDL, against manufacturers and distributors of opioids. The county and city plaintiffs appear to have taken their litigation strategy straight from Big Tobacco playbook of the 1990s. This is to the great disdain of state attorneys general, who fronted Big Tobacco litigation with state-sponsored parens patriae litigation.

The state attorneys general vehemently assert that the MDL claims are the province of state governments rather than local governments. However, the attorney general-led Big Tobacco litigation …

Painfully Prescribed: Could Taking Opioids As Legal Treatment Result In Discrimination Uncovered By The Ada?, Rachael Elyse Palmer

Saint Louis University Journal of Health Law & Policy

Amended in 2008, the Americans with Disabilities Act (ADA), with its sole mission to protect individuals with disabilities, is still gaping with holes in coverage due to recent court interpretations. One such interpretation is the lack of protection for patients being treated with legally prescribed medications. With widespread misconceptions about opioid use and its effects, employers take adverse action upon their employees seeking necessary treatment. This paper will discuss the harmful consequences of courts narrowly interpreting the ADA against coverage of these patients, as well as the potential revitalization of the ADA’s mission in pending actions.

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Could We Pass The Ada Today?: Disability Rights In An Age Of Partisan Polarization, Michael Waterstone

Saint Louis University Journal of Health Law & Policy

No abstract provided.